title: Value of D-dimer and C reactive protein in predicting inhospital death in acute aortic dissection.
abstract: OBJECTIVE
  To evaluate the role of D-dimer and C reactive protein (CRP) in predicting inhospital death in acute aortic dissection (AD).
  
  
  METHODS
  A single-centre prospective study.
  
  
  METHODS
  University hospital in China.
  
  
  METHODS
  114 patients with acute AD.
  
  
  METHODS
  Admission D-dimer and CRP concentrations were assayed.
  
  
  METHODS
  To observe the association of D-dimer and CRP with inhospital death.
  
  
  RESULTS
  Increased levels of plasma D-dimer (9.84±3.53 vs. 4.28±1.99, P < 0.001), CRP (14.08±2.81 vs. 11.18±1.85, P < 0.001) and aortic diameter (45.2±9.5 vs. 40.3±6.0, p = 0.007) were found in dead patients compared with those survived. Moreover, plasma D-dimer concentrations in type A were higher than that in type B (6.51±4.11 vs. 4.87±2.29, p = 0.013). Plasma D-dimer concentrations had positive correlations with CRP levels (r=0.527, P < 0.001) and aortic diameter (r=0.227, p = 0.015), and had negative correlations with the type of AD (r=-0.232, p = 0.013) and the time from onset (r=-0.264, p = 0.005). D-dimer and CRP levels and the type of AD were strongly associated with inhospital mortality. The OR and 95% CI were 3.272, 1.638 to 6.535; 2.322, 1.134 to 4.757; and 0.126, 0.019 to 0.853, respectively. Furthermore, the sensitivity and specificity of D-dimer ≥5.67 μg/mL in predicting inhospital death in acute AD were 90.3% and 75.9% (95% CI 0.85 to 0.96), respectively. Moreover, the sensitivity and specificity of CRP levels ≥11.21 mg/L were 100% and 54.2%, respectively (95% CI 0.74 to 0.89).
  
  
  CONCLUSIONS
  D-dimer ≥5.67 μg/mL, CRP ≥11.21 mg/L and type A acute AD were important risk factors and independently associated with acute AD inhospital death.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung & Blood Vessel Diseases, Beijing 100029, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wen
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Xian-Liang
authors.initials: XL
authors.lastname: Zhou
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D001014:Aortic Aneurysm / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D017052:Hospital Mortality; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein